Implantable medical devices may be used to deliver neurostimulation therapy to patients to treat a variety of symptoms or conditions such as chronic pain, tremor, Parkinson's disease, epilepsy, urinary or fecal incontinence, sexual dysfunction, obesity, or gastroparesis. An implantable medical device may deliver neurostimulation therapy via leads that include electrodes located, for example, proximate to the spinal cord, pelvic nerves, stomach, or peripheral nervous system, or on or within the brain of a patient. In general, the implantable medical device delivers neurostimulation therapy in the form of electrical pulses.
A clinician selects values for a number of programmable parameters in order to define the neurostimulation therapy to be delivered to a patient. For example, the clinician selects an amplitude, which may be a current or voltage amplitude, and pulse width for a stimulation waveform to be delivered to the patient, as well as a rate at which the pulses are to be delivered to the patient. The clinician may also select particular electrodes within an electrode set implanted within the patient to be used to deliver the pulses, and the polarities of the selected electrodes. Selected electrodes and polarities may be referred to as an electrode configuration or combination. A group of parameter values, which may include an electrode configuration, may be referred to as a program in the sense that they drive the neurostimulation therapy to be delivered to the patient.
The process of selecting electrode configurations and parameter values for the stimulation parameters can be time consuming, and may require a great deal of trial and error before one or more preferred stimulation programs are discovered. As a portion of the overall parameter selection process, the process of selecting electrode configurations can be particularly time-consuming and tedious. The clinician typically needs to test a large number of possible electrode configurations within the electrode set implanted in the patient in order to identify preferred electrode configurations. This process is complex, especially for clinicians with limited experience programming stimulation therapy. Commonly, an expert from the manufacturer of the medical device or a specially trained clinician is needed to program the therapy with one or more preferred programs. A “preferred” program or electrode configuration may be a program or electrode configuration that provides a preferable balancing of efficacy, adverse effects, and stimulation device power consumption.